Ye Yan-Mei, Wang Yan-Hong, Ni Li, Liang Jian-Peng, Yu Wei-Wei, Wu Yue-Xian, Zhao Wen-Qu, Xiong Jing, Yao Li-Hong, Cai Shao-Xi, Zhao Hai-Jin
Chronic Airway Diseases Laboratory, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Jun 20;36(7):932-5.
To evaluate fractional exhaled nitric oxide (FENO) level in patients with subacute cough and its value in predicting the patients' response to inhaled corticosteroids (ICS) treatment.
A total of 100 patients with persistent cough lasting more than 3 weeks were enrolled, including 52 patients with subacute cough and 48 with chronic cough. FENO, spirometry, and responses to ICS therapy of the patients were evaluated.
The recruited patients had a median (inter-quartile ranges) FENO level of 19 ppb (12-30 ppb). Patients with chronic cough had a significantly higher median FENO level than those with subacute cough (20.5 vs 16 ppb; Z=-2.245, P=0.025). A FENO level ≥25 ppb was recorded in 15 (28.8%) patients with subacute cough, as compared with 20 (41.6%) in patients with chronic cough (χ(2)=1.801, P=0.179). With a FENO ≥25 ppb as the critical value to justify ICS treatment, 15 patients with subacute cough received ICS and 14 (93.3%) of them showed obvious relief of cough after 2 weeks of therapy, a response rate similar to that of 85.0% (17/20) in patients with chronic cough receiving the treatment (χ(2)=0.588, P=0.443). In patients with subacute cough, those with cough variant asthma (CVA) or eosinophilic bronchitis (EB) had a significantly higher median FENO level than those with postinfectious cough [(16 (11-31) ppb vs 11 (8-19) ppb, P<0.01]. In the etiological analysis, CVA or EB was identified in 23 (44.2%) of the patients with subacute cough, as compared 21 (43.8%) in patients with chronic cough (χ(2)=0.002, P=0.961).
FENO may be an important indicator for etiological diagnosis of subacute cough and for predicting the response to ICS treatment.
评估亚急性咳嗽患者的呼出气一氧化氮（FENO）水平及其预测患者对吸入性糖皮质激素（ICS）治疗反应的价值。
共纳入100例持续性咳嗽超过3周的患者，其中亚急性咳嗽患者52例，慢性咳嗽患者48例。评估患者的FENO、肺功能以及对ICS治疗的反应。
纳入患者的FENO水平中位数（四分位间距）为19 ppb（12 - 30 ppb）。慢性咳嗽患者的FENO水平中位数显著高于亚急性咳嗽患者（20.5 vs 16 ppb；Z = -2.245，P = 0.025）。15例（28.8%）亚急性咳嗽患者的FENO水平≥25 ppb，而慢性咳嗽患者中有20例（41.6%）（χ(2)=1.801，P = 0.179）。以FENO≥25 ppb作为判断是否进行ICS治疗的临界值，15例亚急性咳嗽患者接受了ICS治疗，其中14例（93.3%）在治疗2周后咳嗽明显缓解，这一反应率与接受治疗的慢性咳嗽患者中的85.0%（17/20）相似（χ(2)=0.588，P = 0.443）。在亚急性咳嗽患者中，咳嗽变异性哮喘（CVA）或嗜酸性粒细胞性支气管炎（EB）患者的FENO水平中位数显著高于感染后咳嗽患者[（16（11 - 31）ppb vs 11（8 - 19）ppb，P < 0.01]。病因分析显示，23例（44.2%）亚急性咳嗽患者被诊断为CVA或EB，慢性咳嗽患者中有21例（43.8%）（χ(2)=0.002，P = 0.961）。
FENO可能是亚急性咳嗽病因诊断及预测ICS治疗反应的重要指标。
